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Relationship Violence & Sexual Misconduct (RVSM) Expert Advisory Workgroup

Summary of Research on Trauma and Treatment for Sexual Assault Survivors

What Is The Impact Of Sexual Assault On Survivors’ Health And Well-Being?

Sexual assault is one of the most psychologically damaging forms of trauma and has significant negative impacts on
victims’ health and well-being for years after the assault. 1

Sexual assault victims are at significant risk for developing post-traumatic stress disorder (PTSD). Rates of PTSD
among sexual assault survivors are commensurate with rates documented in combat war veterans. 2

Sexual assault survivors are also at high risk for clinical depression, clinical anxiety, substance abuse, and eating
disorders in addition to PTSD. Sexual assault also causes suicidal thoughts and behaviors. 3

These clinical conditions can persist for years without treatment and symptoms often become more intense during
treatment due to re-activation of memories during treatment. 4

Research also indicates survivors have tremendous strength and resiliency, and they try to manage their symptoms
as best they can so they can continue attending school, working, and participate in life. 5

What Are The Most Pressing And Significant Concerns?

Multiple studies indicate that sexual assault is a significant risk marker for suicide. Survivors may need treatment
for years to manage that risk. 3

What Are Key Considerations In Trauma Treatment?

It can take multiple attempts to find a mental health practitioner who is a good fit for a survivor’s needs, has an
opening in her/his case load, and is qualified to conduct trauma treatment. 6

Treatment times vary by symptom severity, but typically take more than 6 months of intensive work, and require
booster sessions over extended periods of time to address recurring symptoms. 7

Survivors who have suicidal thoughts and behaviors require regular monitoring for years. 3

Most survivors experience “co-morbid” conditions (e.g., PTSD plus depression) that may require sequential
treatment (i.e., one condition must be addressed before others can be addressed), which extends treatment time. 1

Symptoms can become more intense during treatment due to re-activation of memories during treatment. 4

Interruption of treatment is inadvisable because of risks of managing reactivation of memories. 4


How Might Changes in the Healing Assistance Fund Affect Survivors?

If sexual assault survivors have entered into counseling/therapy, interrupting treatment or stopping treatment is
inadvisable for their health and well-being.

If sexual assault survivors have entered into treatment based on the understanding that there were dedicated
funds available to cover the cost of therapy, and then learn that they are no longer eligible for those funds, they
are likely to feel that such changes are a gross violation of trust. This betrayal will likely cause significant distress
that will compound trauma symptoms they are already experiencing.

1Breslau, N., Davis, G. C., Andreski, P., & Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban
population of young adults. Archives of General Psychiatry, 48, 216-222. Replicated by multiple research teams, see: van Dam,
D., Vedel, E., Ehring, T., & Emmelkamp, P. M. (2012). Psychological treatments for concurrent posttraumatic stress disorder and
substance use disorder: A systematic review. Clinical Psychology Review, 32, 202-214.
2Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-
exposed adults. Journal of consulting and clinical psychology, 68, 748-766.

3Campbell, R., Dworkin, E., & Cabral, G. (2009). An ecological model of the impact of sexual assault on women’s mental health.
Trauma, Violence, & Abuse, 10, 225-246. Updated rates documented by: Dworkin, E.R., Menon, S.V., Bystrynski, J., & Allen, N.E.
(2017). Sexual assault victimization and psychopathology: A review and metaanalysis. Clinical Psychology Review, 56, 65-81.

4Foa, E. B., Keane, T. M., Friedman, M. J., & Cohen, J. A. (Eds.). (2008). Effective treatments for PTSD: practice guidelines from
the International Society for Traumatic Stress Studies. Guilford Press.

5 Ullman, S. E. (2014). Correlates of posttraumatic growth in adult sexual assault victims. Traumatology, 20, 219-224.

Davis-Bryant, T. (Ed.) (2011). Surviving sexual violence: A guide to recovery and empowerment. New York: Roman & Littlefield.

Whisman, M. A. (1990). The efficacy of booster maintenance sessions in behavior therapy: Review and methodological
critique. Clinical Psychology Review, 10, 155-170. See also: Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive
processing therapy for PTSD: A comprehensive manual. Guilford Publications.